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Relocating to the US as a doctor

Anyone have any experience of this?

Is the USMLE 100% required to do any work at all? I am not looking to join a training programme etc. I just want to locum as the equivalent of an SHO, with no desire to climb the ranks.

Are there are money saving ways of getting the USLME if so? And how hard is that thing...
(edited 10 years ago)
(edited 10 years ago)
Original post by Ciaran88
Anyone have any experience of this?

Is the USMLE 100% required to do any work at all? I am not looking to join a training programme etc. I just want to locum as the equivalent of an SHO, with no desire to climb the ranks.

Are there are money saving ways of getting the USLME if so? And how hard is that thing...


I've only researched the thing with a view to potentially going on a fellowship at some point, but here's my answers as best as I can.

The US Medical Licensing Exam is required by anyone practising medicine in the US - you need to pass it to get your Medical Licence i.e. the US equivalent of GMC registration, although I believe only parts 1 and 2 are necessary to enter a residency program/fellowship. I've no idea of the requirements for a locum, but parts 1 and 2 would be mandatory.

Whilst I've not looked into it, I do not believe there are any ways of saving money on USMLE, like other official exams (e.g. MRCP, MRCS etc) other than skimping on revision aids/courses. The vast majority of the cost seems to be the exam fees and flying to the US to do Part 2-CS.

I can't comment on the difficulty of the actual exam, but I used USMLE question books to revise for finals - the questions were moderate to hard compared to finals, but certainly easier or comparable to MRCP questions.

More to the point though, why would you want to locum as an SHO grade in US? US doctors only accept those working conditions and poor pay on the understanding it's a temporary thing...
There is no such thing as locuming in the US. You have to take the USMLE. Also Uk training doesn't mean much there so you also need to enter a residency,ie you can't go from being a doc in the Uk to the equivalent there,you need US training. For level of difficulty, go to the USMLE website and look at the syllabus. It's harder than MBBS exams.
Doing a fellowship has slightly different rules, there are certain circumstances where you can do a fellowship there without having done US residency but I don't really know the details.
Original post by AnotherMedic
There is no such thing as locuming in the US.


What makes you say that? A quick google shows plenty of organisations requesting locum doctors in the US. Whatever the healthcare system, there will always be short term service gaps that need locums to fill.

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Reply 5
I've been through the process of transitioning from the UK to the USA medical system. I now live and work in the USA. In order to work in private practice in the USA it is extremely unlikely that any agency or facility will hire a doc who has not:
1. Obtained a licence to practice medicine in the State of interest
2. Obtained either the Board eligibility or Board qualification for the relevant specialty
3. Obtained malpractice insurance coverage or arranged for the agency to procure that. No insurance carrier will offer coverage unless State licencing and Board eligibility or qualification had been achieved.


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Reply 6
Original post by Captain Crash
What makes you say that? A quick google shows plenty of organisations requesting locum doctors in the US. Whatever the healthcare system, there will always be short term service gaps that need locums to fill.

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Yeah, but to do anything in the US you pretty much need to have written the USMLE.


And since he hasn't been online in ages, you can at least stalk his post history about the USMLE. He handed out tons of info while he was here!
Original post by ukmed108
Yeah, but to do anything in the US you pretty much need to have written the USMLE.


I'm pretty sure I said that...
Original post by Captain Crash
What makes you say that? A quick google shows plenty of organisations requesting locum doctors in the US. Whatever the healthcare system, there will always be short term service gaps that need locums to fill.

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What makes me say it is hours and hours of research into the topic and looking up loads of specific hospital and state requirements for foreign doctors as opposed to a quick google which can give you misleading info


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Original post by malaz_197
I think you need the USMLE for any sort of medical work in the US, except for things like fellowships (I think).

out of interest, are the rules for Canada any different?


Yes, Canada is slightly different. For example if you are a fully qualified GP in the UK, you can apply to relocate to areas in Canada that need docs which may or may not be nice places to live. Specialty docs may struggle a bit more to find positions in this way but it's not impossible. Getting a training position in Canada straight after med school though is nearly impossible, maybe a bit of a chance if you're Canadian. So it's easier than US if you're fully trained here in Uk but harder if you wanna train in Canada as they have fewer residency places than US


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Original post by AnotherMedic
What makes me say it is hours and hours of research into the topic and looking up loads of specific hospital and state requirements for foreign doctors as opposed to a quick google which can give you misleading info


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I think you misunderstood my post - I was querying your assertion that there's no such thing as Locum doctors in the US, which there patently are (although they call them Locum Tenens).
Original post by malaz_197
I think you need the USMLE for any sort of medical work in the US, except for things like fellowships (I think).

out of interest, are the rules for Canada any different?


Canada has their own Medical Licensing exam, similar to the USMLE, which you need to pass to work there. However, they also accept as the USMLE as equivalent.
Reply 13
Original post by AnotherMedic


Original post by Captain Crash


Thanks. Stay put in the UK it seems
Original post by Captain Crash
I think you misunderstood my post - I was querying your assertion that there's no such thing as Locum doctors in the US, which there patently are (although they call them Locum Tenens).


I meant for foreign trained doctors. If you are US trained or passed a US residency, then it's a different story I think. Apologies if I misunderstood your query!


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Reply 15
Original post by Captain Crash
Canada has their own Medical Licensing exam, similar to the USMLE, which you need to pass to work there. However, they also accept as the USMLE as equivalent.


No they don't. Canada does not accept the USMLE. You need to write the MCCEE and the NAC OSCE.
Which parts of the USMLE (Step 1, 2CK, 2CS, 3) have to be taken before applying for a residency program, or must they all be finished before applying?
Original post by interstitium
Which parts of the USMLE (Step 1, 2CK, 2CS, 3) have to be taken before applying for a residency program, or must they all be finished before applying?


You need ECFMG certification. Therefore Step 1 and Step 2.

In the very rare instance of obtaining a H1-B visa (and I mean VERY) Step 3 is required. (Or in your best interest) But i researched a bit of time ago. Google is your best bet.

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Reply 18
As a medical student at UCL, can I do the Step 1 and 2 before my finals and then, after the graduation, leave to the USA and train there? Does it all depend on the grades you get Step or is it much more difficult?
Reply 19
Original post by dornam
As a medical student at UCL, can I do the Step 1 and 2 before my finals and then, after the graduation, leave to the USA and train there? Does it all depend on the grades you get Step or is it much more difficult?


Your Step 1 and 2 grades are really important, probably the most important thing. I would advise you to do your electives in the US, because you need reference letters from US doctors and they also like to see that you worked in the US system before. To do an elective you need to pass your Step 1.

The higher the grades on your Step 1 and 2 the easier it is to get a residency. The US pays its specialists infinitely more than the UK does.

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